Drug reference

Diclofenac potassium

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1219, 1220

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Pain and inflammation in rheumatic disease and other musculoskeletal disorders ▶BY MOUTH ▶Child 14–17 years: 75–100 mg daily in 2–3 divided doses ▶Adult: 75–150 mg daily in 2–3 divided doses Acute gout ▶BY MOUTH ▶Adult: 75–150 mg daily in 2–3 divided doses Postoperative pain ▶BY MOUTH ▶Child 9–13 years (body-weight 35 kg and above): Up to 2 mg/kg daily in 3 divided doses; maximum 100 mg per day ▶Child 14–17 years: 75–100 mg daily in 2–3 divided doses ▶Adult: 75–150 mg daily in 2–3 divided doses continued → Migraine ▶BY MOUTH ▶Adult: 50 mg, to be given at onset of migraine, then 50 mg after 2 hours if required, then 50 mg after 4–6 hours; maximum 200 mg per day Fever in ear, nose, or throat infection ▶BY MOUTH ▶Child 9–17 years (body-weight 35 kg and above): Up to 2 mg/kg daily in 3 divided doses; maximum 100 mg per day l UNLICENSED USE Voltarol ® Rapid not licensed for use in children under 14 years or in fever.

PDF pages 1219, 1220

Contra Indications

Active gastro-intestinal bleeding. active gastro-intestinal ulceration. cerebrovascular Musculoskeletal system disease. history of gastro-intestinal bleeding related to previous NSAID therapy. history of gastro-intestinal perforation related to previous NSAID therapy. history of recurrent gastro-intestinal haemorrhage (two or more distinct episodes). history of recurrent gastro-intestinal ulceration (two or more distinct episodes). ischaemic heart disease. mild to severe heart failure. peripheral arterial disease

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Cautions

Allergic disorders. cardiac impairment (NSAIDs may impair renal function). coagulation defects. connective-tissue disorders. dehydration (risk of renal impairment). elderly (risk of serious side-effects and fatalities). history of cardiac failure. history of gastro- intestinal disorders (e.g. ulcerative colitis, Crohn’s disease) . hypertension. oedema. risk factors for cardiovascular events

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Allergy And Cross Sensitivity

Contra-indicated in patients with a history of hypersensitivity to aspirin or any other NSAID—which includes those in whom attacks of asthma, angioedema, urticaria or rhinitis have been precipitated by aspirin or any other NSAID.

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Safety

Interactions

→Appendix 1: NSAIDs

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Side Effects

▶Common or very common Appetite decreased. diarrhoea. dizziness. gastrointestinal discomfort. gastrointestinal disorders. headache. nausea. skin reactions. vertigo. vomiting ▶Uncommon Chest pain. heart failure. myocardial infarction. palpitations ▶Rare or very rare Acute kidney injury. agranulocytosis. alopecia. anaemia. angioedema. anxiety. aplastic anaemia. asthma. confusion. constipation. depression. drowsiness. dyspnoea. erectile dysfunction. fatigue. haemolytic anaemia. haemorrhage. hearing impairment. hepatic disorders. hypersensitivity. hypertension. hypotension. inﬂammatory bowel disease. irritability. leucopenia. memory loss. meningitis aseptic (patients with connective-tissue disorders such as systemic lupus erythematosus may be especially susceptible). nephritis tubulointerstitial. nephrotic syndrome. oedema. oesophageal disorder. oral disorders. pancreatitis. photosensitivity reaction. pneumonitis. proteinuria. psychotic disorder. renal papillary necrosis. seizure. sensation abnormal. severe cutaneous adverse reactions (SCARs). shock. sleep disorders. stroke. taste altered. thrombocytopenia. tinnitus. tremor. vasculitis. vision disorders ▶Frequency not known Hallucination. malaise. optic neuritis SIDE-EFFECTS, FURTHER INFORMATION For information about cardiovascular and gastrointestinal side-effects, and a possible exacerbation of symptoms in asthma, see Non- steroidal anti-inﬂammatory drugs p. 1193.

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Conception And Contraception

Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.

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Pregnancy

Avoid unless the potential beneﬁt outweighs the risk. Avoid during the third trimester (risk of closure of fetal ductus arteriosus in utero and possibly persistent pulmonary hypertension of the newborn); onset of labour may be delayed and duration may be increased.

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Breast Feeding

Use with caution during breast-feeding. Amount in milk too small to be harmful.

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Hepatic Impairment

Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.

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Renal Impairment

Avoid if possible or use with caution. Avoid in severe impairment. Dose adjustments The lowest effective dose should be used for the shortest possible duration. Monitoring In renal impairment monitor renal function; sodium and water retention may occur and renal function may deteriorate, possibly leading to renal failure.

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Dose and formulations

Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Tablet CAUTIONARY AND ADVISORY LABELS 21 ▶Diclofenac potassium (Non-proprietary) Diclofenac potassium 25 mg Diclofenac potassium 25mg tablets | 28 tablet P £3.86 DT = £3.86 Diclofenac potassium 50 mg Diclofenac potassium 50mg tablets | 28 tablet P £7.41 DT = £7.41 ▶Voltarol Rapid (Novartis Pharmaceuticals UK Ltd) Diclofenac potassium 50 mg Voltarol Rapid 50mg tablets | 30 tablet P £7.94

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Clinical care

Patient And Carer Advice

Medicines for Children leaflet: Diclofenac for pain and inflammation www.medicinesforchildren.org.uk/diclofenac- pain-and-inflammation

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Dose text by age group

Child 14–17 years

75–100 mg daily in 2–3 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 9–13 years (body-weight 35 kg and above)

Up to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 14–17 years

75–100 mg daily in 2–3 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 9–17 years (body-weight 35 kg and above)

Up to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1220

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Diclofenac potassium

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1219, 1220

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF pages 1219, 1220

Contra Indications

PDF page 1220

Cautions

PDF page 1220

Allergy And Cross Sensitivity

PDF page 1220

Safety

Interactions

→Appendix 1: NSAIDs

PDF page 1220

Side Effects

PDF page 1220

Conception And Contraception

Caution—long-term use of some NSAIDs is associated with reduced female fertility, which is reversible on stopping treatment.

PDF page 1220

Pregnancy

PDF page 1220

Breast Feeding

Use with caution during breast-feeding. Amount in milk too small to be harmful.

PDF page 1220

Hepatic Impairment

Manufacturer advises caution in mild to moderate impairment; avoid in severe impairment.

PDF page 1220

Renal Impairment

PDF page 1220

Dose and formulations

Medicinal Forms

PDF page 1220

Clinical care

Patient And Carer Advice

Medicines for Children leaflet: Diclofenac for pain and inflammation www.medicinesforchildren.org.uk/diclofenac- pain-and-inflammation

PDF page 1220

Dose text by age group

Child 14–17 years

75–100 mg daily in 2–3 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 9–13 years (body-weight 35 kg and above)

Up to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 14–17 years

75–100 mg daily in 2–3 divided doses

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1219

Child 9–17 years (body-weight 35 kg and above)

Up to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1220

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.